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Essay on Nursing Theory: Uncertainty in Illness

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Uncertainty, according to the theory put into place by Merle Mishel, is the inablility to determine the meaning of illness-related events because of a lack of sufficient cues that allow patients to assign value to objects or events and accurately predict outcomes (Elphee, 2008). This author believes it is important for nurses to completely understand the patient as a whole and what they are experiencing when faced with a new and frightening diagnosis. It is necessary to supply patients with sufficient information regarding their diagnosis, if they desire. This author believes the Theory of Uncertainty may help the nurse understand more fully what challenges and uncertainty the patient is presented with when undergoing a new diagnosis.
Mishel’s Uncertainty of Illness Theory is a middle-range theory indicating the theory is not overly broad or narrow (Black, 2014). The theory was developed from studying men with prostate cancer who were watchfully waiting for the advancing signs of their disease (Black, 2014). The theory has three main components, which incorporate: the antecedents of uncertainty, impaired cognitive appraisal, and coping with uncertainty in illness (Neville, 2003). The antecedents of Mishel’s theory are the stimulus frame, cognitive capacities and event congruence (Neville, 2003). The stimulus frame concerns three parts including: symptom pattern, event familiarity and event congruency (Neville, 2003). Symptom pattern may be when symptoms of illness present with consistency to form a pattern (Elphee, 2008). Event familiarity refers to the repetitive nature of the healthcare environment and not necessarily the physical characteristics of the disease (Elphee, 2008). Elphee also defines event congruence as the cor...


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...s if the patient is in the know.



References
Black, B. P., & Chitty, K. K. (2014). Professional nursing: Concepts & challenges(7th ed.). St. Louis, Missouri: Saunders.
Elphee, E. E. (2008). Understanding the Concept of Uncertainty in Patients With Indolent Lymphoma. Oncology Nursing Forum, 35(3), 449-454.
Kazer, M. W., Jr., D. E., & Whittemore, R. (2010). Out of the Black Box: Expansion of a Theory-Based Intervention to Self-Manage the Uncertainty Associated With Active Surveillance (AS) for Prostate Cancer. Research and Theory for Nursing Practice,24(2), 101-112.
Neville, K. L. (2003). Uncertainty in Illness: An Integrative Review. Orthopaedic Nursing,22(3), 206-214.
Suzuki Phd, RN, AOCNP, M. (2012). Quality of Life, Uncertainty, and Perceived Involvement in Decision Making in Patients With Head and Neck Cancer. Oncology Nursing Forum, 39(6), 541-548.



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